A successful intra-pleural fibrinolytic therapy with alteplase in a patient with empyematous multiloculated chylothorax

Chylothorax is a collection of chyle in the pleural cavity resulting from leakage of lymphatic vessels, usually from the thoracic duct. In majority of cases, chylothoraxis a bacteriostatic pleural effusion. Incidence of infected or even empyematous chylothorax are not common. Here, we report a case of a 57-year-old man with end stage renal disease and complete central venous stenosis who presented with recurrent right-sided chylothorax. It was complicated with sepsis and multilocated empyema and treated successfully with intra-pleural fibrinolytic therapy using alteplase.